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CSL Seqirus: Are we doingenough forelderly patientswith dry eye?

Dry eye disease (DED) is one of the most prevalent eye diseases that remains widely underestimated in Aged Care. To explore this further, we talked to leading optometrist Dr. Jennifer Rayner, co-founder of South Australia’s first standalone dry eye clinic, about the significance and solutions for DED.

Q: Could you explain the link between advancing age and the risk of developing DED?

Dr. Rayner: “Certainly. As people age, they produce fewer tears and may have a reduced capacity to distribute and drain tears due to anatomical changes. Additionally, the presence of other age-related conditions, such as diabetes, stroke, arthritis, autoimmune diseases, eye surgery, and certain medications like hormone replacement therapy, pain medication, antidepressants, anticholinergic drugs, and topical antiglaucoma medications, can also collectively contribute to their increased risk." 

Q: How does DED affect the life quality for elderly Australians? 

Dr. Rayner: “The discomfort, pain, and irritation associated with the condition can negatively affect their physical and mental well-being. Blurred vision can interfere with daily activities and this visual impairment can even lead to a higher risk of falls and injuries, further diminishing their quality of life. Watery eyes are also a significant issue that may cause some elderly patients with dry eye to give up on activities and keep their eyes closed to avoid the discomfort.”

Q: Could you explain the role of tears in relation to DED?

Dr. Rayner: “Of course. The eye's surface is covered by a tear film that consists of three main layers that keep the eye moist, lubricated, and protected from injury and infection. However, when there is an imbalance, it can lead to an increase in tear evaporation and a reduction in tear production and cause DED symptoms that, if left untreated, can worsen over time and cause damage to the eye's surface.”

Q: What are the recommended treatments for DED?

Dr. Rayner: “For symptom relief, the initial step is to use artificial tears. It's important to note that not all artificial tear productswork the same way, so it's crucial to choose one that suits the individual's needs.”

Q: Are there specific considerations when selecting an artificial tear?

Dr. Rayner: “Yes, there are. An artificial tear that treats all layers of the tear film can help restore the imbalance we see with DED. Retention is also important; using a longer-lasting product can reduce the frequency of eye drop usage, thereby reducing the medication burden for the elderly. Choosing a preservative-free option without harmful additives means its gentle enough for daily use. I recommend a brand that offers the choice of a bottle or single-use ampoule for more flexibility and convenience. Lastly, it is also worth noting that some artificial tears do more than lubricate the eyes; they create a barrier giving the eye the time to heal.”

Q: To conclude, are there any other recommendations for managing DED?

Dr. Rayner: “Alongside artificial tears, maintaining good eyelid hygiene is important. Applying a warm compress to the eyelids and making environmental adjustments, such as redirecting fans or heaters away from the face, can also help. Treating associated medical conditions, reviewing current medications with a doctor, and encouraging regular blinking throughout the day are further strategies to help manage DED.”

This article has been sponsored by CSL Seqirus. AU-Cati-23-0071.

Dr. Jennifer Rayner

BAppSc (Optom), GradCertOcTher (UNSW)

Alleve Eye Clinic

1800 008 275


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